Philadelphia Reflections

The musings of a physician who has served the community for over six decades

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.American and European Unions, Compared(1)
The (1648) Treaty of Westphalia created the modern nation-state by respecting sovereignty within agreed boundaries. Soon, everyone had a sovereign King. Today, Europeans live in republics, but wish to unite for economic benefits. Like others however, they found that hard to do, and so began with monetary union, alone. Unlucky timing: world monetary crisis suddenly struck.

SECTION TWO: Hidden Economics of Healthcare
Here are samplings of the reasons Healthcare Reform still isn't going anywhere.

Is It Better to Die in America?

The purpose of healthcare financing is to redistribute the pain of paying for it. Otherwise, the patient doesn't want to be sick or die; illness itself is a disincentive to abuse. The concern about abuse mainly arises when someone else pays for it. The indigent patient doesn't want to be sick, either, but somehow that's different. Not only does the public resent the cost, the public resents the need for the cost, as well.

Two of the central figures in devising Obamacare -- supposedly free healthcare for everyone -- have framed the issue as whether it is better to die in America or somewhere else. Just about no one wants to die anywhere, at any time I notice. The mortality figures are too fuzzy to judge whether the extra cost is worth the money, but essentially there isn't enough provable difference among developed nations to assert most care lengthens the lifespan of the patients. Especially the cancer patients. Apparently, the diffusion speed of new knowledge makes it impossible to tell how much it helped. Or else the amount of new knowledge isn't sufficient to show up in such crude data. By that standard, medical care is just as "good", one place or another, one insurance system or another. It just costs more, that's all. When some research laboratory finds a cure for cancer, health care still won't seem to have proved it helped.

But life expectancy will increase; in the long run costs will come down. It can be very confidently assumed that those who invest their savings early in life will enjoy a more prosperous retirement than those who depend on entitlements.

 

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